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Ethnic differences in satisfaction with mental health services among representative people with psychosis in South London: PRiSM Study 4

  • Sue E. Parkman (a1), Sara N. Davies (a2), Morven Leese (a3), Michael Phelan (a4) and Graham Thornicroft (a3)...



Previous studies show that among Black Caribbeans there is a higher prevalence of schizophrenia and higher levels of both voluntary and compulsory admissions. These suggest that Black Caribbean patients may find psychiatric services less appropriate to their needs. The aim of this study was to establish the satisfaction with mental health services of representative psychosis patients in South London, especially in relation to ethnic group.


A random sample of all cases of psychotic disorder identified in the two sectors was interviewed using the Verona Service Satisfaction Schedule. Questionnaires from 50 Black Caribbean patients and 134 White patients were analysed.


Black Caribbean patients, particularly those of second generation born in the UK, were significantly less satisfied with almost every aspect of the services that they received than either older Black Caribbean patients born in the Caribbean or White patients. Using multiple regression analysis it was found that among the younger Black Caribbean patients, unlike the other patients, the number of previous admissions was a significant predictor of dissatisfaction.


Patients' ratings of satisfaction with mental health services are significantly worse for UK-born Black Caribbean than other patients with psychotic disorder in South London.


Corresponding author

Dr Leese, Section of Community Psychiatry, Institute of Psychiatry, De Crespigny Park, London SE5 8EF


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Bhul, K., Foulds, G., Baubin, F., et al (1995) Developing culturally sensitive psychiatric community services. British Journal of Health Care Management, 16, 817822.
Davies, S., Thornicroft, G., Leese, M., et al (1996) Ethnic differences in the risk of compulsory psychiatric admissions among representative cases of psychosis in London. British Medical Journal, 312, 533537.
Department of Health (1991) Patient's Charter. London: DoH.
Dunn, J. & Fahy, T. (1990) Police admissions to a psychiatric hospital. Demographic and clinical differences between ethnic groups. British Journal of Psychiatry, 156, 373378.
Francis, E., David, J., Johnson, N., et al (1989) Black people and psychiatry in the UK – an alternative to institutional care. Psychiatric Bulletin, 13, 482485.
Harrison, G., Owens, D., Holton, A., et al (1988) A prospective study of severe mental disorder in Afro-Caribbean patients. Psychological Medicine, 18, 643657.
Harrison, G., Holton, A., Neilson, D., et al (1989) Severe mental disorder in Afro-Caribbean patients: some social, demographic and service factors. Psychological Medicine, 19, 683696.
Kalman, T. P. (1983) An overview of patient satisfaction with psychiatric treatment. Hospital and Community Psychiatry, 34, 4854.
Littlewood, R. (1986) Ethnic minorities and the Mental Health Act. Patterns of explanation. Psychiatric Bulletin, 10, 306308.
Littlewood, R. & Lipsedge, M. (1981) Some social and phenomenological characteristics of psychotic immigrants. Psychological Medicine, 11, 289302.
McGovern, D. & Cope, R. (1987) The compulsory detention of males of different ethnic groups, with special reference to offender patients. British Journal of Psychiatry, 150, 505512.
McGovern, D. & Cope, R. (1991) Second generation of Afro-Caribbeans and young Whites with a first admission diagnosis of schizophrenia. Social Psychiatry and Psychiatric Epidemiology, 26, 9599.
McGovern, D. & Hammings, P. (1994) A follow-up of second generation Afro-Caribbeans and White British with a first admission diagnosis of schizophrenia: attitudes to mental illness and psychiatric services of patients and relatives. Social Science and Medicine, 38, 117127.
McGuffin, P., Farmer, A. E. & Harvey, I. H. (1991) A polydiagnostic application of operational criteria in studies of psychotic illness: development and reliability of the OPCRIT system. Archives of General Psychiatry, 48, 764770.
McKenzie, K., van Os, J., Fahy, T., et al (1995) Psychosis with good prognosis in Afro-Caribbean people now living in the United Kingdom. British Medical Journal, 311, 13251328.
Moodley, P. & Thornicroft, G. (1988) Ethnic group and compulsory detention. Medicine, Science and the Low, 28, 324328.
OPCS and GRO(S) (1992) 1991 Census Definitions. London: HMSO.
Owens, D., Harrison, G. & Boot, D. (1991) Ethnic factors in voluntary and compulsory admissions. Psychological Medicine, 21, 185196.
Pipe, R., Bhat, A., Matthews, B., et al (1991) Section 136 and African/Afro-Caribbean Minorities. International Journal of Social Psychiatry, 37, 1423.
Ruggeri, M. (1994) Patients' and relatives' satisfaction with psychiatric services: the state of the art of its measurement. Social Psychiatry and Psychiatric Epidemiology, 29, 212227.
Ruggeri, M. & Dall'Agnola, R. (1993) The development and use of the Verona Expectations for Care Scale (VECS) and the Verona Service Satisfaction Scale (VSSS) for measuring expectations and satisfaction with community-based psychiatric services in patients, relatives and professionals. Psychological Medicine, 23, 511523.
Senior, P. A. & Bhopal, R. (1994) Ethnicity as a variable in epidemiological research. British Medical Journal, 309, 327330.
Simes, R. J. (1986) An improved Bonferroni procedure with multiple tests of significance. Biometrika, 73, 751754.
Turner, T. H., Ness, M. N. & Imison, C. T. (1992) Mentally disordered persons found in public places. Diagnostic and social aspects of police referrals (Section 136). Psychological Medicine, 22, 765774.
Ware, J. E., Davies-Avery, A. & Stewart, A. I. (1978) The measurement and meaning of patient satisfaction. Health and Medical Care Services Review, 1, 215.
World Health Organization (1992) Tenth Revision of the International Classification of Diseases and Related Health Problems. Clinical Descriptions and diagnostic guidelines. Geneva: WHO.
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  • ISSN: 0007-1250
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Ethnic differences in satisfaction with mental health services among representative people with psychosis in South London: PRiSM Study 4

  • Sue E. Parkman (a1), Sara N. Davies (a2), Morven Leese (a3), Michael Phelan (a4) and Graham Thornicroft (a3)...
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